生殖医学杂志2025，Vol.34Issue(10)：1328-1335,8.DOI:10.3969/j.issn.1004-3845.2025.10.005
GnRH拮抗剂方案下体外受精的最佳授精浓度探索与分析
Exploration and analysis of optimal insemination concentration for in vitro fertilization in gonadotrophin-releasing hormone antagonist protocol
摘要
Abstract
Objectives:To explore the range of optimal insemination concentration for in vitro fertilization(IVF)cycles using the gonadotrophin-releasing hormone(GnRH)antagonist protocol. Methods:Fertilization of 6 703 oocytes from IVF cycles using the GnRH antagonist protocol for ovarian stimulation in the Reproductive Medicine Center of Dongguan Songshan Lake Central Hospital affiliated to Guangdong Medical University from July 2015 to June 2023 were analyzed retrospectively.The final insemination concentration and the sperm/oocyte ratio were taken as independent variables.Fertilization rate,normal fertilization rate and polyspermy rate were taken as dependent variables.Smooth curve fitting and threshold effect analysis were carried out on Empower software. Results:The curves of final insemination concentration with respect to fertilization rate and normal fertilization rate were"inverted U shape".When the final insemination concentration was less than 6× 104/ml,every increase of 104/ml increased the fertilization rate by 11％[OR=1.11,95％CI(1.02,1.20),P＜0.05]and normal fertilization rate by 9％[OR=1.09,95％CI(1.02,1.17),P＜0.05].When the final insemination concentration was not less than 6 × 104/ml,every increase of 104/ml decreased the fertilization rate by 7％[OR=0.93,95％CI(0.87,1.00),P＞0.05]and normal fertilization rate by 5％[OR=0.95,95％CI(0.89,1.01),P＞0.05].The curves of sperm/oocyte ratio with respect to fertilization rate and normal fertilization rate first showed a"plateau period"and then a significant decline.When the sperm/oocyte ratio was over 5×104,every increase of 104 sperm/oocyte decreased the fertilization rate by 71％[OR=0.29,95％CI(0.16,0.55),P＜0.001]and normal fertilization rate by 70％[OR=0.30,95％CI(0.15,0.58),P＜0.001].The curve of sperm/oocyte ratio and polyspermy rate was"U"shaped.When the sperm/oocyte ratio was not less than 2.4 × 104 sperm/oocyte,every increase of 104 sperm/oocyte increased the polyspermy rate by 37％[OR=1.37,95％CI(1.04,1.81),P＜0.05]. Conclusions:Using a four well dish as a carrier for fertilization,when the insemination concentration is in the range of(5-7)×104/ml and the sperm/oocyte ratio is in the range of(2-3)×104,IVF cycles with GnRH antagonist protocol have a high normal fertilization rate(＞60％)as well as a low polyspermy rate(＜7％).关键词
授精浓度/体外受精/正常受精率/多精受精率/GnRH拮抗剂方案Key words
Insemination concentration/In vitro fertilization/Normal fertilization rate/Polyspermy rate/Gonadotrophin-releasing hormone antagonist protocol分类
临床医学引用本文复制引用
黄佩颖,胡绵达,潘瑞华,何红梅,李青洋,孙晓岩,赵丽,陈博..GnRH拮抗剂方案下体外受精的最佳授精浓度探索与分析[J].生殖医学杂志,2025,34(10):1328-1335,8.基金项目
广东省中医药局中医药科研项目(20221416) （20221416）
